| NPI | 1386172633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA JEAN KUBESH Administrator/President 320-522-0718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 9111) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2024-04-03 |